The Inuit are often cited as an example of a culture that has lived for hundreds of years on a low-carbohydrate diet.[42] However, in multiple studies the traditional Inuit diet has not been shown to be a ketogenic diet.[43][44][45][46] Not only have multiple researchers been unable to detect any evidence of ketosis resulting from the traditional Inuit diet, but the ratios of fatty-acid to glucose were observed at well below the generally accepted level of ketogenesis.[44][47][45][46] Furthermore, studies investigating the fat yields from fully dressed wild ungulates, and the dietary habits of the cultures who rely on them, suggest that they are too lean to support a ketogenic diet.[48][49] With limited access to fat and carbohydrates, cultures such as the Nunamiut Eskimos—who relied heavily on caribou for subsistence—annually traded for fat and seaweed with coastal-dwelling Taremiut.[48]
^ Lawrie 2014, pp. 92-. "A much delayed onset of rigor mortis has been observed in the muscle of the whale (Marsh, 1952b). The ATP level and the pH may remain at their high in vivo values for as much as 24h at 37ºC. No adequate explanation of this phenomenon has yet been given; but the low basal metabolic rate of whale muscle (Benedict, 1958), in combination with the high content of oxymyoglobin in vivo (cf 4.3.1), may permit aerobic metabolism to continue slowly for some time after the death of the animal, whereby ATP levels can be maintained sufficiently to delay the union of actin and myosin in rigor mortis."

Normal dietary fat contains mostly long-chain triglycerides (LCTs). Medium-chain triglycerides (MCTs) are more ketogenic than LCTs because they generate more ketones per unit of energy when metabolised. Their use allows for a diet with a lower proportion of fat and a greater proportion of protein and carbohydrate,[18] leading to more food choices and larger portion sizes.[4] The original MCT diet developed by Peter Huttenlocher in the 1970s derived 60% of its calories from MCT oil.[15] Consuming that quantity of MCT oil caused abdominal cramps, diarrhea, and vomiting in some children. A figure of 45% is regarded as a balance between achieving good ketosis and minimising gastrointestinal complaints. The classical and modified MCT ketogenic diets are equally effective and differences in tolerability are not statistically significant.[9] The MCT diet is less popular in the United States; MCT oil is more expensive than other dietary fats and is not covered by insurance companies.[18]

A short-lived increase in seizure frequency may occur during illness or if ketone levels fluctuate. The diet may be modified if seizure frequency remains high, or the child is losing weight.[19] Loss of seizure-control may come from unexpected sources. Even "sugar-free" food can contain carbohydrates such as maltodextrin, sorbitol, starch, and fructose. The sorbitol content of suntan lotion and other skincare products may be high enough for some to be absorbed through the skin and thus negate ketosis.[31]

Hi Maya. I LOVE your site!! Interesting, informative with fab recipes and ideas. Hubby and I have just started eating low carb and I have to say, we are not finding it too difficult and I already feel sooo much better!! I find the hardest part is choosing low carb veg, I feel as if we are not eating enough. Any suggestions on how to get more veggies into our diet?
That was really interesting and useful information. But I wanted to ask you about what Dom said at time (52min). What does he mean,when he says 1 mml increase is about 10% increase of substrate to the brain? Is that (same glucose amount in brain) + (typical ketone amount in brain)+ and 10% more? Or does it substitute glucose? And if it is so, does the brain use that energy or does it just stay around the brain without being used? I know we can’t know for sure, but it would be helpful if you said what you think. Thanks in advance!
Infants and patients fed via a gastrostomy tube can also be given a ketogenic diet. Parents make up a prescribed powdered formula, such as KetoCal, into a liquid feed.[19] Gastrostomy feeding avoids any issues with palatability, and bottle-fed infants readily accept the ketogenic formula.[31] Some studies have found this liquid feed to be more efficacious and associated with lower total cholesterol than a solid ketogenic diet.[18] KetoCal is a nutritionally complete food containing milk protein and is supplemented with amino acids, fat, carbohydrate, vitamins, minerals and trace elements. It is used to administer the 4:1 ratio classic ketogenic diet in children over one year. The formula is available in both 3:1 and 4:1 ratios, either unflavoured or in an artificially sweetened vanilla flavour and is suitable for tube or oral feeding.[51] Other formula products include KetoVolve[52] and Ketonia.[53] Alternatively, a liquid ketogenic diet may be produced by combining Ross Carbohydrate Free soy formula with Microlipid and Polycose.[53]
The question then is whether your crotch is like your mouth. Not in general, but in the specific case of ketones. That is, when you are on the keto diet, can ketones also accumulate in your crotch area and then subsequently lead to a new smell? Moreover, if you are woman, could ketones be changing the acidity of your vagina, which then may produce an environment more favorable to certain types of microorganisms? Indeed, the smell of your vagina can depend on the composition of microorganisms there. Some odors, like a strong fishy one, can be the result of an overgrowth of certain microorganisms like bacteria, which is the case in bacterial vaginosis.
Carbohydrates are necessary for the conversion of inactive thyroid hormone to active thyroid hormone, and if you’re on an extremely strict low carbohydrate diet, then you may actually be limiting this conversion. Your TSH is what tells your thyroid gland to “release more hormone,” so your TSH rises when your thyroid gland is underactive, or conversion of inactive to active thyroid hormone is inadequate. A high TSH means that the pituitary gland is releasing its hormone to try to get the thyroid to respond and produce more thyroid hormone. Because of inadequate carbohydrates, TSH will often elevate in a high-fat, low-carber – indicating potential for long-term thyroid and metabolic damage.
Me, I was a lot of things before I was keto: vegan, high starch, skinny, an Adderall abuser, paleo, Catholic, raw till 4, pescatarian, etc. The reason I went high fat/low carb was because some very smart-sounding people on the internet told me that I could “hack my body” and eat some fun things (bacon) if only I’d cut out a food group that was probably giving me constipation and cancer anyway.
So which MCT to pick? Brain Octane (pure C8) provides the fastest rise in ketones and burns the cleanest, with minimal gut irritation. XCT oil is more affordable but works more slowly with less direct cognitive effects. The capric acid C10 in XCT Oil doesn’t break down into ketones as quickly as pure caprylic C8, but capric acid C10 is more affordable, so you can save money by going with the XCT oil. XCT oil still goes to brain energy, just not as quickly as Brain Octane. Both can be used for energy without processing by the liver, unlike many other fats and oils.
Protein will induce an insulin response in the body, if consumed in high amounts. The most intuitive way to start a keto diet for most people is by removing all of the carbs they have been eating. Typically people will replace those calories by increasing their lean meat consumption. That's a recipe for disaster! Keeping protein moderate is an often overlooked, but very important part of a keto diet. Most people need around 0.6g to 1.0g of protein per pound of lean body mass.